CAJ | 학술논문

目的探讨影响短暂性脑缺血发作(TIA)进展为脑梗死的因素.方法经临床检查确诊TIA患者及由TIA进展为脑梗死患者在急性期先行常规16排螺旋CT横断面平扫,然后根据临床症状及体征,选择拟诊感兴趣平面,行脑CT灌注扫描(CTPI)和CT血管造影(CTA).总结 2 组患者的发作次数、发作持续时间及危险因素并进行统计学分析.结果由TIA进展为脑梗死组△r CBF值与发作次数呈正相关,2组患者的CTPI值、发作次数、发作持续时间及危险因素比较有统计学意义(P=0.0009).CTA检查显示由TIA进展为脑梗死患者均有与病灶区相关的脑动脉主干或分支的狭窄,而TIA患者中仅有2例患者大脑后动脉有轻度狭窄,且与患者临床表现不相符.结论 TIA 进展为脑梗死与△r CBF下降程度、发作次数、发作持续时间及颅内动脉狭窄有密切的关系.对于有多次或发作时间长的TIA患者,应进一步行头颅CTPI和CTA检查,了解颅内脑组织血流灌注情况及有无动脉狭窄,积极治疗以预防缺血性卒中的发生.
목적 탐토영향단잠성뇌결혈발작(TIA)진전위뇌경사적인소.방법 경림상검사학진TIA환자급유TIA진전위뇌경사환자재급성기선행상규16배라선CT횡단면평소,연후근거림상증상급체정,선택의진감흥취평면,행뇌CT관주소묘(CTPI)화CT혈관조영(CTA).총결 2 조환자적발작차수、발작지속시간급위험인소병진행통계학분석.결과 유TIA진전위뇌경사조△r CBF치여발작차수정정상관,2조환자적CTPI치、발작차수、발작지속시간급위험인소비교유통계학의의(P=0.0009).CTA검사현시유TIA진전위뇌경사환자균유여병조구상관적뇌동맥주간혹분지적협착,이TIA환자중부유2례환자대뇌후동맥유경도협착,차여환자림상표현불상부.결론 TIA 진전위뇌경사여△r CBF하강정도、발작차수、발작지속시간급로내동맥협착유밀절적관계.대우유다차혹발작시간장적TIA환자,응진일보행두로CTPI화CTA검사,료해로내뇌조직혈류관주정황급유무동맥협착,적겁치료이예방결혈성졸중적발생.
Objective The CT perfusion imaging of TIA and cerebral infarction (CI) resulting from TIA were compared to explore the possible influential factors for the process of TIA changing into infarction. Methods Patients clinically diagnosed ofTlA (TIA group) or CI from TIA (CI group) first took noncontrast CT scanning in a-cute phase. The positive planes were picked up according to the clinical symptoms and signs to perform CT perfusion (CTP) and CT angiography (CTA). The attack frequency, the duration of symptoms and risk factors of the two groups were summarized and statistically analyzed. Results The value of △rCBF in CI group was positively correla-ted with attack frequency. TIA group was significantly different from CI group in CTPI value, frequency and duration of attacks, and risk factors. Conclusions Progress of TIA changing into CI is closely related to the decreasing of △rCBF, attack frequency and duration and intracranial artery stenosis. For TIA patients with frequent or long-time attacks, CTP and CTA can get information of the cerebral blood flow and artery stenosis for prevention of ischemic stroke.